YVONNE SCOTT WALLACE LCSW - NPI 1265521827

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

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About Yvonne Scott Wallace Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YVONNE SCOTT WALLACE LCSW (NPI 1265521827) is an individual mental health provider in Tucker, Georgia, licensed in Georgia (CSW001009) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1978).

NPPES Registry Identity

NPI1265521827

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameYVONNE SCOTT WALLACECredential: LCSW

Location Address3912 CEDAR CIRTucker, GA 30084-7339

Mailing Address3912 Cedar CirTucker, GA 30084-7339 · (770) 414-9742 · Fax (770) 414-8286

Phone(770) 414-9742

Fax(770) 414-8296

Sole ProprietorNo

Medical School CMSOtherGraduated 1978

Enumeration DateOctober 12, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1265521827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in GA · CSW001009

3912 CEDAR CIR, Tucker, GA 30084

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Yvonne Scott Wallace Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971606252

PECOS Enrollment IDI20120125000183

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.